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Endotracheal Intubation I: Procedure

Endotracheal Intubation I: Procedure

Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...

Endotracheal Intubation II: Nursing Management

Endotracheal Intubation II: Nursing Management

Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...

Endotracheal Tube Extubation

Endotracheal Tube Extubation

Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals.

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway interventions are...

Cardiopulmonary Resuscitation II: ACLS Airway Management

Cardiopulmonary Resuscitation II: ACLS Airway Management

Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned under...

Tracheostomy Care II: Procedure

Tracheostomy Care II: Procedure

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Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask and...

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Related Experiment Video

Updated: May 27, 2026

The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation

The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation

Published on: August 2, 2024

[Awake fibrecapnic intubation].

Johannes M Huitink¹

¹VU Medisch Centrum, afd. Anesthesiologie, Amsterdam, the Netherlands. j.huitink@vumc.nl

Nederlands Tijdschrift Voor Geneeskunde

|November 10, 2011

Summary

A new awake fibrecapnic intubation technique simplifies managing difficult airways in head and neck cancer patients. This method, utilizing capnography via a special catheter, offers a potentially easier alternative to standard awake flexible intubation.

Area of Science:

Anesthesiology
Respiratory Medicine
Otolaryngology

Context:

Awake flexible intubation is standard for difficult airways, but has a failure rate up to 13%.
Patients with head and neck cancer often present with challenging airway anatomy.
Managing difficult airways requires specialized and reliable techniques.

Purpose:

To describe a novel 'awake fibrecapnic intubation' technique for patients with head and neck cancer and difficult airways.
To evaluate the feasibility and potential advantages of this new method compared to traditional awake flexible intubation.

Summary:

The technique involves topical anesthesia, insertion of a flexible fibrescope, and advancement of a specialized suction catheter for capnography and oxygenation.
Spontaneous respiration is maintained throughout the procedure.

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Guidelines for Elective Pediatric Fiberoptic Intubation

Guidelines for Elective Pediatric Fiberoptic Intubation

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Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

Published on: January 13, 2017

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Last Updated: May 27, 2026

The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation

The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation

Published on: August 2, 2024

Guidelines for Elective Pediatric Fiberoptic Intubation

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

Published on: January 13, 2017

The fibrescope is advanced over the catheter to place the tracheal tube upon confirmation of tracheal placement via capnograms.

Impact:

Awake fibrecapnic intubation may offer a simpler and potentially more effective approach to difficult airway management.
This technique could reduce the failure rate associated with conventional methods.
It provides a valuable new option for anesthesiologists managing high-risk patients.